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1.
Participation in school sports among children and adolescents with juvenile idiopathic arthritis in the German National Paediatric Rheumatologic Database, 2000-2015: results from a prospective observational cohort study.
Milatz, F, Klotsche, J, Niewerth, M, Geisemeyer, N, Trauzeddel, R, Weißbarth-Riedel, E, Kallinich, T, Peitz, J, Hartmann, M, Minden, K
Pediatric rheumatology online journal. 2019;(1):6
Abstract
BACKGROUND Regular school sports can help adolescents achieve the recommended amount of daily physical activity and provide knowledge, attitudes and behavioral skills that are needed in order to adopt and maintain a physically active lifestyle. Furthermore, it reaches all children including those that are at risk for engaging in more sedentary types of behavior. Since adolescents with juvenile idiopathic arthritis (JIA) are less involved in physical and social activities than their healthy peers, the objectives were to (1) estimate the prevalence of participation in school sports among patients with JIA; (2) determine the correlates associated with school sports absenteeism; and (3) investigate whether attendance in school sports has changed in the era of biologics. METHODS Data from schoolchildren with JIA recorded in the German National Paediatric Rheumatologic Database (NPRD) in the years 2000 to 2015 were considered for the analyses. Data from the year 2015 were inspected to analyze correlates of school sports absenteeism. Whether school sports participation had changed between 2000 and 2015 was determined using linear mixed models. RESULTS During the 15-year period, the participation rates in school sports were determined in 23,016 patients. The proportion of patients who participated in school sports almost always steadily increased from 31% in 2000 to 64% in 2015 (β = 0.017, 95% confidence interval (CI) 0.015, 0.020), whereas the exemption rate simultaneously decreased from 44% in 2000 to 16% in 2015 [β = - 0.009, 95% CI -0.011, - 0.007]. In 2015, the data from 5879 patients (mean age 13.1 ± 3.3 years, female 65%, disease duration 5.9 ± 4.0 years, persistent oligoarthritis 37%) were available for evaluation. Full exemption from school sports (in 16.1% of cases) was associated with functional limitations, disease activity and any use of DMARDs, intra-articular glucocorticoid injections or physiotherapy. CONCLUSIONS School sports attendance among children and adolescents with JIA has increased significantly over the past 15 years. Possible explanations include improved functional ability probably due to better treatment options. The integration of patients with child acceptable symptom states who have previously been fully exempted from school sports needs to be addressed in the future.
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2.
Association Between Occupational, Sport, and Leisure Related Physical Activity and Baroreflex Sensitivity: The Paris Prospective Study III.
Climie, RE, Boutouyrie, P, Perier, MC, Chaussade, E, Plichart, M, Offredo, L, Guibout, C, van Sloten, TT, Thomas, F, Pannier, B, et al
Hypertension (Dallas, Tex. : 1979). 2019;(6):1476-1483
Abstract
Physical activity (PA) is a preventative behavior for noncommunicable disease. However, little consideration is given as to whether different domains of PA have differing associations with health outcomes. We sought to determine the association between occupational, sport, leisure, and total PA with baroreflex sensitivity (BRS), distinguishing between neural (nBRS) and mechanical (mBRS) BRS. In a cross-sectional analysis of 8649 adults aged 50 to 75 years, resting nBRS (estimated by low-frequency gain, from carotid distension rate and heart rate) and mBRS (carotid stiffness) were measured by high-precision carotid echo-tracking. PA was self-reported using the validated Baecke questionnaire. The associations between PA and nBRS and mBRS were quantified using multivariate linear regression analysis, separately in the working and nonworking population. In working adults (n=5039), occupational PA was associated with worse nBRS (unstandardized β=-0.02; [95% CI, -0.04 to -0.003]; P=0.022) whereas sport PA was associated with better nBRS (β=0.04; [95% CI, 0.02-0.07]; P=0.003) and mBRS (β=-0.05; [95% CI, -0.09 to -0.00001]; P=0.049). Neither leisure PA nor total PA was associated with nBRS or mBRS. In nonworking adults (n=3610), sport PA and total PA were associated with better mBRS (β=-0.08; [95% CI, -0.15 to 0.02]; P=0.012 and β=-0.05; [95% CI, -0.10 to 0.009]; P=0.018) but not nBRS. These findings suggest differential associations between domains of PA and BRS and may provide insights into the mechanisms underlying the association between occupational PA and cardiovascular disease.
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3.
Sport-based physical activity recommendations and modifications in C-reactive protein and arterial thickness.
Cayres, SU, de Lira, FS, Kemper, HCG, Codogno, JS, Barbosa, MF, Fernandes, RA
European journal of pediatrics. 2018;(4):551-558
Abstract
UNLABELLED We analyzed the effects of 1 year of engagement in ≥ 300 min/week of organized sports on inflammatory levels and vascular structure in adolescents. The sample was composed of 89 adolescents (11.6 ± 0.7 years old [43 boys and 46 girls]), stratified according to engagement in ≥ 300 min/week of sport practice during at least 12 months of follow-up (n = 15, sport practice; n = 74, non-sport practice). Arterial thickness (carotid and femoral) was assessed by ultrasound scan, while high sensitive C-reactive protein levels were used to assess inflammatory status. Trunk fatness (densitometry scanner), biological maturation (age at peak height velocity), blood pressure, and skipping breakfast were treated as covariates. Independently of body fatness and biological maturation, the group engaged in sports presented a higher reduction in C-reactive protein (mean difference -1.559 mg/L [95%CI -2.539 to -0.579]) than the non-sport group (mean difference -0.414 mg/L [95%CI -0.846 to 0.017]) (p = 0.040). There was a significant relationship between changes in C-reactive protein and changes in femoral intima-media thickness in the non-sport group (r = 0.311 [95%CI 0.026 to 0.549]). CONCLUSION Inflammation decreased in adolescents engaged in organized sports, independently of trunk fatness and biological maturation. Moreover, inflammation was related to arterial thickening only in adolescents not engaged in sports. What is Known: • Intima media thickness is a relevant marker of cardiovascular disease in pediatric groups, being affected by obesity and inflammation. • The importance of monitoring inflammatory markers from childhood is enhanced by the fact that alterations in these inflammatory markers in early life predict inflammation and alterations in carotid IMT in adulthood. What is New: • Anti-inflammatory properties related to physical exercise performed at moderate intensity, on inflammation and alterations in IMT are not clear in pediatric groups. • Due to the importance that sport participation has assumed as a promoter of improvements in health and quality of life, it is necessary to understand its potential benefits for cardiovascular health during human growth.
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4.
Characterization and Comparison of Nutritional Intake between Preparatory and Competitive Phase of Highly Trained Athletes.
Nunes, CL, Matias, CN, Santos, DA, Morgado, JP, Monteiro, CP, Sousa, M, Minderico, CS, Rocha, PM, St-Onge, MP, Sardinha, LB, et al
Medicina (Kaunas, Lithuania). 2018;(3)
Abstract
Background and objective: For a high level athlete, it is essential to ensure optimal energy as well as macro- and micro-nutrient and fluid intakes, in order to improve their performance during training and competition. Protein intake should be 1.2⁻2.1 g/kg/d, whereas the requirements for carbohydrate and fat intakes should be >5g/kg/d and 20⁻35% of energy, respectively. The micronutrient and fluid intakes in athletes were compared to the Dietary Reference Intake (DRI) and European Food Safety Authority (EFSA) recommendations, respectively. This study aimed to characterize and compare the nutritional habits of athletes at the preparatory and competitive phase, and to test if their nutritional intakes were in accordance with the recommendations. Materials and methods: A total of 276 professional athletes were assessed. To evaluate their nutritional intake, the athletes completed a 7 days food record. Under reporting was defined using a ratio of energy intake to basal metabolic rate (BMR) of 1.1. Body composition was assessed using dual energy X-ray absorptiometry (DXA). Results: Almost half (49%) of the athletes from the final sample reported lower measured intakes of carbohydrates and 27% reported a higher consumption of proteins than what was recommended. In both the preparatory and competitive phases, the micronutrients with a higher mismatch between the actual and recommended intakes were vitamins D and E, magnesium, folate, calcium, and zinc for both sexes, and iron intake for females. A large proportion of athletes reported a lower water intake. Compared to the recommendations, males reported a higher intake of carbohydrates, lipids, vitamins E, calcium, and magnesium (p <0.05) in the competitive phase, while females reported a lower ingestion of water, vitamins A and D, and calcium (p <0.05) in the preparatory phase. Conclusions: Overall, in the preparatory and competitive phases of the season, athletes reported a macro- and micro-nutrient intake below the recommendations, especially in the female athletic population. Dietary intakes in athletes need to be optimized and adjusted to their requirements, according to sex and sport, so as to avoid compromising health and performance.
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5.
Sports Practices and Cardiovascular Risk in Teenagers.
Scherr, C, Fabiano, LCC, Guerra, RL, Belém, LHJ, Câmara, ACG, Campos, A
Arquivos brasileiros de cardiologia. 2018;(3):248-255
Abstract
BACKGROUND Cardiovascular diseases are the leading cause of deaths in the world, and many events could be prevented by healthy life habits. OBJECTIVES To compare the occurrence of cardiovascular risk factors in adolescents enrolled at public schools in the city of Rio de Janeiro, including a renowned school for sport practices. METHODS Cross-sectional study, convenience sampling of 422 students enrolled at the Experimental Olympic Gymnasium (EOG) and at Figueiredo Pimentel School (FP). Using descriptive analyses, continuous variables were expressed as mean and standard deviation or median and interquartile ranges, and the Student's t-test or the chi-square test, respectively, was used for comparisons. The sports were classified according to the metabolic equivalent of task (MET) (below or above 5). RESULTS We included 274 students enrolled at the EOG and 148 at FP. Mean age was similar between schools -12.5 ± 1.6 years at FP and 12.6 ± 0.9 at the EOG; 65.5% of the students at FP and 43.8% of the students at the EOG were female (p < 0.01). Significant differences in the prevalence of hypertension (20% vs. 6.3%, p < 0.01) and borderline cholesterol levels (27.7% vs. 17.3%, p = 0.01) were found between FP and EOG students, respectively. CONCLUSION High prevalence of hypertension, overweight/obesity and altered blood lipid profile was found in this group of adolescents. Regular sports training program combined with little influence of their eating habits outside school may contribute to a better metabolic profile and reduction in cardiovascular risk factors in students. Public health measures are also need.
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Cardiovascular risk profiles of world masters games participants.
Climstein, M, Walsh, J, Debeliso, M, Heazlewood, T, Sevene, T, Adams, K
The Journal of sports medicine and physical fitness. 2018;(4):489-496
Abstract
BACKGROUND Increasing evidence indicates adherence to exercise throughout life is concurrent with improved health. World masters games (WMG) have more participants than any other international sporting competition and is under investigated, particularly with regard to indices of cardiovascular disease risk. Therefore, we chose to investigate selected cardiovascular risk factors in WMG participants. METHODS This was a cross-sectional, observational study which utilized a web-based questionnaire to survey cardiovascular risk factors of WMG participants. The survey consisted of three sections: basic demographics, medical history and physiological parameters which included Body Mass Index (BMI), waist circumference (WC), resting blood pressure (BP) and lipids (total cholesterol [TC], high density lipoprotein [HDL] and low density lipoprotein [LDL]). RESULTS A total of 1435 participants, 872 male, aged 27-91 years (mean age 54.99 years) participated in the study. Key findings included significant differences (P<0.05) between genders in BMI (17.7%, P<0.001), WC (10.6%, P<0.001), resting SBP (5.8%, P<0.001) and resting DBP (4.8%, P<0.001). Significant differences were also found between genders in HDLs (15.2%, P<0.001), TC:HDL ratio (17.2%, P<0.001) and LDL:HDL ratio (19.0%, P<0.001). Significant differences (P<0.001) were also identified when comparing WMG lipid results to the Australian general population (TC P<0.001; HDLs P<0.001; LDLs P<0.001). CONCLUSIONS A high percentage of WMG participants demonstrated optimal values in a number of cardiovascular disease (CVD) risk factors when compared to the general population, female WMG participants had better values as compared to males. This reflected a decreased CVD in WMG participants and supports our hypothesis of enhanced health characteristics in an active, but aged cohort.
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7.
Do Dynamic Fat and Fat-Free Mass Changes follow Theoretical Driven Rules in Athletes?
Silva, AM, Matias, CN, Santos, DA, Rocha, PM, Minderico, CS, Thomas, D, Heymsfield, SB, Sardinha, LB
Medicine and science in sports and exercise. 2017;(10):2086-2092
Abstract
INTRODUCTION Maximizing fat mass (FM) loss while preserving or increasing fat-free mass (FFM) is a central goal for athletic performance but the composition of body weight (BW) changes over time with training are largely unknown. PURPOSE We aimed to analyze FM and FFM contributions to BW changes and to test if these contributions follow established rules and predictions over one athletic season. METHODS Seventy athletes (42 men; handball, volleyball, basketball, triathlon, and swimming) were evaluated from the beginning to the competitive stage of the season and were empirically divided into those who lost (n = 20) or gained >1.5% BW (n = 50). FM and FFM were evaluated with a four-compartment model. Energy densities (ED) of 1.0 kcal·g for FFM and 9.5 kcal·g for FM were used to calculate ED/per kilogram BW change. RESULTS Athletes that lost >1.5% BW decreased FM by 1.7 ± 1.6 kg (P < 0.05), whereas FFM loss was nonsignificant (-0.7 ± 2.1 kg). Those who gained >1.5% BW increased FFM by 2.3 ± 2.1 kg (P < 0.05) with nonsignificant FM gains (0.4 ± 2.2 kg). The proportion of BW change as FM for those who lost or gained BW was 90% (ED: 8678 ± 2147 kcal·kg) and 5% (ED: 1449 ± 1525 kcal·kg), respectively (P < 0.001). FFM changes from Forbes Curve were inversely related to observed changes (r = -0.64; r = -0.81, respectively for those who lost or gained BW). CONCLUSIONS Athletes that lost BW used 90% of the energy from FM while in those gaining BW, 95% was directed to FFM. When BW is lost, dynamic changes in its composition do not follow established rules and predictions used for lean or overweight/obese nonathletic populations.
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8.
Compensatory Changes in Energy Balance Regulation over One Athletic Season.
Silva, AM, Matias, CN, Santos, DA, Thomas, D, Bosy-Westphal, A, MüLLER, MJ, Heymsfield, SB, Sardinha, LB
Medicine and science in sports and exercise. 2017;(6):1229-1235
Abstract
PURPOSE Mechanisms in energy balance (EB) regulation may include compensatory changes in energy intake (EI) and metabolic adaption (MA), but information is unavailable in athletes who often change EB components. We aim to investigate EB regulation compensatory mechanisms over one athletic season. METHODS Fifty-seven athletes (39 males/18 females; handball, volleyball, basketball, triathlon, and swimming) were evaluated from the beginning to the competitive phase of the season. Resting and total energy expenditure (REE and TEE, respectively) were assessed by indirect calorimetry and doubly labeled water, respectively, and physical activity energy expenditure was determined as TEE - 0.1(TEE) - REE. Fat mass (FM) and fat-free mass (FFM) were evaluated by dual-energy x-ray absorptiometry and changed body energy stores was determined by 1.0(ΔFFM/Δtime) + 9.5(ΔFM/Δtime). EI was derived as TEE + EB. REE was predicted from baseline FFM, FM, sex, and sports. %MA was calculated as 100(measured REE/predicted REE-1) and MA (kcal) as %MA/100 multiplied by baseline measured REE. Average EI minus average physical activity energy expenditure was computed as a proxy of average energy availability, assuming that a constant nonexercise EE occurred over the season. RESULTS Body mass increased by 0.8 ± 2.5 kg (P < 0.05), but a large individual variability was found ranging from -6.1 to 5.2 kg. The TEE raise (16.8% ± 11.7%) was compensated by an increase EI change (16.3% ± 12.0%) for the whole group (P < 0.05). MA was found in triathletes, sparing 128 ± 168 kcal·d, and basketball players, dissipating 168 ± 205 kcal·d (P < 0.05). MA was associated (P < 0.05) with EB and energy availability (r = 0.356 and r = 0.0644, respectively). CONCLUSION TEE increased over the season without relevant mean changes in weight, suggesting that EI compensation likely occurred. The thrifty or spendthrift phenotypes observed among sports and the demanding workloads these athletes are exposed to highlight the need for sport-specific energy requirements.
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9.
Energy Balance over One Athletic Season.
Silva, AM, Matias, CN, Santos, DA, Thomas, D, Bosy-Westphal, A, Müller, MJ, Heymsfield, SB, Sardinha, LB
Medicine and science in sports and exercise. 2017;(8):1724-1733
Abstract
INTRODUCTION Magnitude and variation in energy balance (EB) components over an athletic season are largely unknown. PURPOSE We investigated the longitudinal changes in EB over one season and explored the association between EB variation and change in the main fat-free mass (FFM) components in highly trained athletes. METHODS Eighty athletes (54 males; handball, volleyball, basketball, triathlete, and swimming) were evaluated from the beginning of the season to the main competition stage. Resting and total energy expenditure (REE and TEE, respectively) were assessed by indirect calorimetry and doubly labeled water, respectively. Physical activity energy expenditure was calculated as TEE - 0.1 TEE - REE. Fat mass (FM), FFM, and bone mineral were evaluated with dual-energy x-ray absorptiometry; changed body energy stores were calculated as 1.0(ΔFFM/Δtime) + 9.5(ΔFM/Δtime). Total-body water (TBW) and its compartments were assessed through dilution techniques, and total-body protein was calculated from a four-compartment model, with body volume assessed by air displacement plethysmography. RESULTS Although a negative EB of -17.4 ± 72.7 kcal·d was observed (P < 0.05), EB varied widely among sports and across sex groups resulting in a net weight increase (0.7 ± 2.3 kg) that is attributable to significant changes in FFM (1.2 ± 1.6 kg) and FM (-0.7 ± 1.5 kg) (P < 0.05). EB was related with TBW and intracellular water (r = 0.354, r = 0.257, P < 0.05, respectively), regardless of sex, sports, and age. CONCLUSIONS The mean negative EB observed over the season resulted from the rate of FM use and FFM accretion, but with a large variation by sex and sports. TBW, but not total-body protein or mineral balance, explained the magnitude of EB, which means that athletes under a positive or a negative EB showed a TBW expansion or shrinkage, respectively, specifically within the cells, over one athletic season.